勃起障礙與缺血性心臟病的雙向研究: 以台灣全人口基礎的世代研究

以作者查詢圖書館館藏

、以作者查詢臺灣博碩士

、以作者查詢全國書目

、勘誤回報

、線上人數：13

、訪客IP：3.20.205.228

姓名

王孔良(Kung-Liang Wang) 查詢紙本館藏

畢業系所

資訊工程學系在職專班

論文名稱

勃起障礙與缺血性心臟病的雙向研究: 以台灣全人口基礎的世代研究
(A bidirectional study between erectile dysfunction and ischemic heart disease: A population-based cohort study in Taiwan)

相關論文

★ 應用嵌入式系統於呼吸肌肉群訓練儀之系統開發	★ 基質輔助雷射脫附飛行時間式串聯質譜儀微生物抗藥性資料視覺化工具
★ 使用穿戴式裝置分析心律變異及偵測心律不整之應用程式	★ 建立一個自動化分析系統用來分析任何兩種疾病之間的關聯性透過世代研究設計以及使用承保抽樣歸人檔
★ 青光眼病患併發糖尿病,使用Metformin及Sulfonylurea治療得到中風之風險:以台灣人口為基礎的觀察性研究	★ 利用組成識別和序列及空間特性構成之預測系統來針對蛋白質交互作用上的特殊區段點位進行分析及預測辨識
★ 新聞語意特徵擷取流程設計與股價變化關聯性分析	★ 藥物與疾病關聯性自動化分析平台設計與實作
★ 建立財務報告自動分析系統進行股價預測	★ 建立一個分析疾病與癌症關聯性的自動化系統
★ 基於慣性感測器虛擬鍵盤之設計與實作	★ 一個醫療照護監測系統之實作
★ 應用手機開發手握球握力及相關資料之量測	★ 利用關聯分析全面性的搜索癌症關聯疾病
★ 全面性尋找類風濕性關節炎之關聯疾病	★ 利用機器學習法估算台灣無測站區域之PM2.5濃度

檔案

[Endnote RIS 格式]

[Bibtex 格式]

[相關文章]

[文章引用]

[完整記錄]

[館藏目錄]

至系統瀏覽論文 ( 永不開放)

摘要(中)

勃起功能障礙，另又名為陽痿，是一種常見的男性私密疾病，這種疾病是無法勃起或者維持勃起狀況來滿足性活動。此外，勃起障礙已經被指出與缺血性心臟病為相同疾病的不同表現。勃起障礙病患而言，一般認為會受年齡所影響且好發在中老年的男性病患。因此，我們從全民健康保險研究資料庫取出40歲以上的新發勃起障礙病患，然後評估對於缺血性心臟病風險上的影響。之前大多數的研究都是在探討勃起障礙是否會引起缺血性心臟病的風險，本論文的研究提出考量雙向彼此間風險的影響。本論文研究結果顯示，勃起障礙的病患與非勃起障礙病患相比，勃起障礙病患有顯著增加缺血性心臟病風險 (HR =1.58, 95% CI=1.3-1.94)，缺血性心臟病的病患與非缺血性心臟病病患相比，缺血性心臟病病患有顯著增加勃起障礙風險(HR =1.72, 95% CI=1.43-2.06)。

摘要(英)

Erectile dysfunction, as known as impotence, is a common male and private disorder disease, which is the inability to achieve or sustain an erection for satisfactory sexual activity. In addition, erectile dysfunction has been noted with ischemic heart disease as different manifestations of the same disease. Patients with erectile dysfunction, it is generally believed that male patients will be affected by the age and often occurs in elderly. Therefore, we crawl from the National Health Insurance Research Database 40 years of age patients with new onset of erectile dysfunction, and then the assessment of ischemic heart disease risks. Most previous studies explore whether erectile dysfunction can cause the risk of ischemic heart diseases. In this study, we present the impact of each other between two-way risks. Studies have shown that patients with erectile dysfunction compared to patients without erectile dysfunction, patients with erectile dysfunction have a significant increase in the risk of ischemic heart disease (HR = 1.58, 95% CI = 1.3-1.94), patients with ischemic heart disease compared to patients without ischemic heart disease, patients had a significant increase in the risk of erectile dysfunction (HR = 1.72, 95% CI = 1.43-2.06).

關鍵字(中)

★ 勃起障礙
★ 缺血性心臟病
★ 世代研究
★ 雙向研究

關鍵字(英)

★ erectile dysfunction
★ ischemic heart disease
★ cohort study
★ bidirectional study

論文目次

Table of Contents
摘要 i
ABSTRACT ii
Table of Contents iii
List of Figures v
List of Tables vi
Chapter 1 Introduction 1
1.1 Background. 1
1.2 Related Works 1
1.3 Motivation. 4
1.4 Research Goal 4
Chapter 2 Materials and Methods 6
2.1 Data Sources 6
2.2 Main Disease Definition 6
2.3 Study Cohort Selection 6
2.4 Confounding Factors 11
2.5 Statistical Analysis 11
Chapter 3 Erectile Dysfunction Effects 13
3.1 Demographic Characteristics 13
3.2 Incidence and hazard ratios of Ischemic Heart Disease between two group by demographic characteristics 16
3.3 Incidence and hazard ratios of Ischemic Heart Disease between two group by comorbidity 20
3.4 Sensitive analysis from Erectile Dysfunction exposure 23
3.5 Kaplan-Meier Ischemic Heart Disease-Free Survival Curves 24
Chapter 4 Ischemic Heart Disease Effects 25
4.1 Demographic Characteristics 25
4.2 Incidence and hazard ratios of Erectile Dysfunction between two group by demographic characteristics 28
4.3 Incidence and hazard ratios of Erectile Dysfunction between two group by comorbidity 32
4.4 Sensitive analysis from Ischemic Heart Disease exposure 35
4.5 Kaplan-Meier Erectile Dysfunction-Free Survival Curves 36
Chapter 5 Discussions 37
Chapter 6 Conclusions 42
References 43
Appendix I ICD9 CODES 46
Appendix II Urbanization level 47

List of Figures
Figure 2.1. ED-IHD Flowchart of experimental design 8
Figure 2.2. IHD-ED Flowchart of experimental design 10
Figure 3.1. Probability free of IHD for patients without and with ED 24
Figure 4.1. Probability free of ED for patients without and with IHD 36

List of Tables
Table 1.1. Summary of similar study 3
Table 3.1. Demographic characteristics between patients with or without ED 14
Table 3.2. Incidence rates and adjusted hazard ratios of developing IHD stratified by age and comorbidity, insurance premium, geographic location, urbanization level 17
Table 3.3. Incidence rates and adjusted hazard ratios of IHD by comorbidities 21
Table 3.4. Sensitive anaylysis examining the adjusted hazard ratios of different lag time from
exposure(ED) 23
Table 4.1. Demographic characteristics between patients with or without IHD 26
Table 4.2. Incidence rates and adjusted hazard ratios of developing ED stratified by age and comorbidity, insurance premium, geographic location, urbanization level 29
Table 4.3. Incidence rates and adjusted hazard ratios of ED by comorbidities 33
Table 4.4. Sensitive anaylysis examining the adjusted hazard ratios of different lag time from
exposure(IHD) 35
Table 5.1. Comparison between Table 3.1 and 4.1 40
Table 5.2. Comparison between Table 3.2 and 4.2 41
Table 5.3. Comparison between Table 3.3 and 4.3 41
Table 5.4. Comparison between Table 3.4 and 4.4 42
Table 5.5. Comparison between Figure 3.1 and 4.1　42

參考文獻

1. Criqui MH, Vargas V, Denenberg JO, et al. Ethnicity and peripheral arterial disease: the San
Diego Population Study. Circulation 2005; 112: 2703-7.
2. Chen YJ, Lin MS, Hsu KY, Chen CR, Chen CM, Chen W. Prevalence of Asymptomatic
Peripheral Arterial Disease and Related Risk Factors in Younger and Elderly Patients in Taiwan. Angiology 2014; 65: 396-401.
3. Aponte J. The prevalence of peripheral arterial disease (PAD) and PAD risk factors among
different ethnic groups in the US population. J Vasc Nurs 2012; 30: 37-43.
4. Tekin N, Baskan M, Yesilkayali T, Karabay O. Prevalence of peripheral arterial disease and
related risk factors in Turkish elders. BMC Fam Pract 2011; 12: 96.
5. NIH Consensus Conference Impotence. NIH consensus development panel on impotence.
JAMA. 1993;270:83–90.
6. Lue TF. Erectile dysfunction. N Engl J Med. 2000;342:1802–1813.
7. Gades NM, Nehra A, Jacobson DJ, McGree ME, Girman CJ, et al. Association between
smoking and erectile dysfunction: a population based study Am J Epidemiol. 2005 Feb 15;161(4):346-51.
8. Te-Chun Shen, Wei Chen, Cheng-Li Lin , et al. Chronic Obstructive Pulmonary Disease is.
Associated with an Increased Risk of. Peripheral Arterial Disease. 內科學誌 2014 25 272-280.
9. Virag R, Bouilly P. Is impotence an arterial disease? A study of arterial risk factors in 440
impotent men. Lancet 1985;322:181–184.
10. Montorsi P, Ravagnani PM, Galli S, et al. The artery size hypothesis: a macrovascular link
between erectile dysfunction and coronary artery disease. Am J Cardiol.2005;96(12B):19M-23M.
11. Elesber AA, Solomon H, Lennon RJ, et al. Coronary endothelial dysfunction is associated
with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early
atherosclerosis. Eur Heart J. 2006;27(7):824-831.
12. TS Polonsky, LA Taillon, H Sheth, et al. The association between erectile dysfunction and peripheral arterial disease as determined by screening ankle-brachial index testing. Atherosclerosis 2009, 207(2):440-444.
13. Te-Chun Shen, Wei Chen, Cheng-Li Lin , et al. Risk of Erectile Dysfunction in Chronic Obstructive Pulmonary Disease: A Population-based Cohort Study in Taiwan, MEDICINE, 2015 Apr, 94(14):e448-e448
14. Polonsky TS, Taillon LA, et al. The association between erectile dysfunction and peripheral arterial disease as determined by screening ankle-brachial index testing. Atherosclerosis. 2009 Dec;207(2):440-4.
15. Meller SM, Stilp E, Walker CN, et al. The link between vasculogenic erectile dysfunction, coronary artery disease, and peripheral artery disease: role of metabolic factors and endovascular therapy. J Invasive Cardiol. 2013 Jun;25(6):313-9.
16. JUAN CK, Chen HJ, Shen JL, Kao CH, et al. Lichen Simplex Chronicus Associated With Erectile Dysfunction: A Population-Based Retrospective Cohort Study. PLoS One. 2015;10:e0128869.
17. Hsu CY, Lin CL, Kao CH. Gout is associated with organic and psychogenic erectile dysfunction. Eur J Intern Med. 2015 Jun 15. pii: S0953-6205(15)00206-X.
18. Karen Okrainec,Devi K. Banerjee, and Mark J. Eisenberg , et al. Coronary artery disease in the developing world . Am Heart J 2004;148:7–15.
19. Beaglehole R. International trends in coronary heart disease mortality and incidence rates. J Cardiovasc Risk 1999;6:63–8.
20. Yu-Chun Chen, Hsiao-Yun Yehb, Jau-Ching Wu, et al. Taiwan′s National Health Insurance Research Database:Administrative Health Care Database as Study Object in Bibliometrics. Scientometrics 86(2):365-380.
21. H. Shi, F. R. Zhang, C. X. Zhu, et al. Incidence of changes and predictive factors for sexual
function after coronary stenting. Andrologia. 2007 Feb;39(1):16-21.
22. Justo D, Mashav N, Arbel Y, et al. Increased erythrocyte aggregation in men with coronary artery disease and erectile dysfunction. International Journal of Impotence Research(2009) 21, 192–197; doi:10.1038/ijir.2009.6
23. Akilli H, Gok H, Soylu A, et al. Severity of coronary artery disease and symptoms of erectile dysfunction in males with a positive exercise treadmill test. Int J Urol. 2007 Aug;14(8):733-7
24. Gazzaruso C, Solerte SB, Pujia A, et al. Erectile dysfunction as a predictor of cardiovascular events and death in diabetic patients with angiographically proven asymptomatic coronary artery disease: a potential protective role for statins and 5-phosphodiesterase inhibitors. J Am Coll Cardiol 2008;51:2040–4.
25. Ma RC, So WY, Yang X, et al. Erectile dysfunction predicts coronary heart disease in type 2 diabetes. J Am Coll Cardiol 2008;51:2045–50.
26.Inman BA, Sauver JL, Jacobson DJ, et al. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 2009;84:108–13.
27. Araujo AB, Travison TG, Ganz P, et al. Erectile dysfunction and mortality. J Sex Med 2009;6:2445–54.
28. Gandaglia G1, Briganti A1, Jackson G, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol. 2014 May;65(5):968-78. doi: 10.1016/j.eururo.2013.08.023.
29. Chung SD, Chen YK, Kang JH, et al. Population-based estimates of medical comorbidities in erectile dysfunction in a Taiwanese population. J Sex Med. 2011 Dec;8(12):3316-24. doi: 10.1111/j.
30. Roumeguère T, Wespes E, Carpentier Y, et al. Erectile Dysfunction Is Associated with a High Prevalence of Hyperlipidemia and Coronary Heart Disease Risk. Eur Urol. 2003 Sep;44(3):355-9.
31. Aleksandar Štulhofer, Žarko Bajić. Safarinejad MR. Prevalence and risk factors for erectile dysfunction in a population-based study in Iran. Int J Impot Res. 2003;15:246-52.
32. Montorsi P, Ravagnani PM, Galli S, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J. 2006 Nov;27(22):2632-9.
33. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61.
34. Kostis JB, Jackson G, Rosen R, et al. Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference). Am J Cardiol 2005;96:313–321.
35. Kaiser DR, Billups K, Mason C, et al. Impaired brachial artery endothelium-dependent and –independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004;43:179–184.
36. Montorsi P, Montorsi F, Schulman C. Is erectile dysfunction the ‘tip of the iceberg’of a systemic vascular disorder? Eur Urol 2003;44:352–354.
37. Solomon H, Man JW, Jackson G. Erectile dysfunction and the cardiovascular patient:
endothelial dysfunction is the common denominator. Heart 2003;89:251–253.

指導教授

洪炯宗(Jorng-Tzong Horng)

審核日期

2016-7-20

推文